Prefilled syringes versus vials: Impact on vaccination efficiency and patient safety in Indian private market

Background and aimConsidering the proportion of unsafe injection practices in India, an evaluation of the potential improvement in vaccination with prefilled syringe (PFS) compared to SDV and MDV (single and multidose vials) in Indian private market is the objective of this paper.MethodAn observational, open label, randomized 2-phase time and motion study involved comparison in terms of efficiency associated with the vaccine administration process (preparation, injection, and disposal) and rate of handling errors with safety implications.SettingFive Indian pediatric vaccination centers.ParticipantsForty vaccinators (8 per center). 10 observers.Main outcome measuresTime taken for each activity cycle; frequency of errors observed (Phase 1); time for 10 consecutive injections (Phase 2).ResultsThe mean time required to perform a vaccination with PFS was 47.6 ± 11.7 s and was twice as fast as with vials (p < 0.0001). The mean number of handling errors with PFS was 1.1 ± 1.7 and was 3 times fewer than with vials (p < 0.0001).ConclusionsCompared with vials, PFS are productivity enhancers, as they decrease time required to perform vaccinations and reduce wastage. PFS are also risk reducers, as they reduced the occurrence of handling errors and associated health hazard risks by a factor of 3.Actual cost comparison was not part of the study. But this study has shown that use of PFS is associated with cost reduction in terms of saving time correlated with man hours and reducing wastage.